The U.S. Justice Department has filed suit against a doctors group practice accused of adding unnecessary billing linked to blood and liver tests. “The cornerstone of Medicare is that the government believes it can trust the doctor to not steal.”

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Qui Tam Damages and Awards

Anyone with substantive, insider knowledge regarding fraudulent claims against the government should consider bringing a qui tam whistleblower lawsuit, as delineated by the False Claims Act (FCA). Since the 1986 revision of the FCA, which made it easier for a citizen to bring a whistleblower suit successfully, many billions have been recovered. Recoveries from January 2009 to the end of fiscal year 2015 have amounted to $26.4 billion, with $19.4 billion of that amount from qui tam actions. Whistleblowers have taken down $3 billion in awards.

So What is a Qui Tam Action?

A qui tam action is one in which a citizen brings a case on behalf of the government that alleges fraud. The two-word phrase is shorthand for a Latin phrase that essentially means you are suing for the government as well as yourself. The FCA has qui tam provisions that allow any citizen to sue individuals, companies, or organizations for fraudulent claims submitted to the government.

Such false claims for payment can originate with submitting false records, false statements, or other fraudulent representations.

The fact that everyday citizens can bring such cases helps the government recover ill-gotten gains as well as take down enterprises devoted to criminal activity. Under the FCA, qui tam whistleblowers are known as relators, who are eligible for awards based on the recovered damages.

Award Factors in Qui Tam Whistleblower Suits

The creators of the FCA allowed wide latitude when it comes to determining how much a qui tam whistleblower can recover. The court hearing the case decides the exact amount of the award. Generally speaking, those who report fraud promptly, providing substantial assistance, will receive a larger percentage of damages. Certain other factors can come into play, including:

How much government involvement occurs in the suit

The origin of the information regarding the false claims

The participation, if any, in the fraud by the person bringing the suit. Usually, a person who participated in the fraud under certain kinds of threats is not penalized for any role they played.

No more than 10 percent of damages if the government joins in the action and it is based on information revealed in a public report or in testimony

Between 15 and 25 percent of damages if the government joins in the suit, depending on the level of participation in the suit by the initiator

Between 25 and 30 percent of damages if the government does not join in the suit. This amount can be reduced if the person bringing the action was responsible for the fraud.

The FCA also allows whistleblowers to recover their legal fees and costs from whoever committed the fraud.

Top 10 Lists: SEC Whistleblower Awards

The passing of the federal government’s fiscal year (FY) 2016, which ran from October 1, 2015, to September 30, 2016, marked a historic occasion: SEC whistleblower awards exceeded the $57 million mark, with the money given to 13 whistleblowers. Since the program began roughly five years ago, the SEC had awarded $111 million to 34 whistleblowers by the end of FY 2016. If we extend the time period to the end of December, 2016, the awards total $135 million and were granted to 36 whistleblowers.

Can I Bring a Qui Tam Case?

If you have substantive claims of fraud against the government that are backed up with evidence, broadly speaking, you have a case. It doesn’t matter who you are. Usually, whistleblowers are current or former employees, as they are most likely to have the necessary information, but a number of other individuals or groups can initiate qui tam suits:

State governments

Local governments

Federal or other government employees

Subcontractors

Competitors

Customers

Patients

Others with relevant information.

Essential Facts to Remember

If you think you have a case, keep the following facts in mind:

File your claim of fraudulent activity before six years expires.

Your evidence cannot be sourced from publicly-available records, such as court records, stories in the media, hearings, or requests based on the Freedom of Information Act (FOIA request).

Federal money must be at issue.

The fraud must have been deliberately executed. Simple mismanagement or incompetence is not grounds for a case under the FCA.

Whistleblower Procedures for Filing a Qui Tam Suit

Whistleblowers play a vital role in our society. They point out fraud and help stop corruption that costs taxpayers significant sums of money. It’s easy to see why whistleblowers are seen as providing a public service.

In cases where fraud is being perpetrated against the government (and, by extension, the people), whistleblowers seek justice through what is known as a “qui tam suit.” Qui tam cases have helped the government recover billions of dollars lost to fraud.

The Whistleblower Lawyer.

If you think you have the facts needed to bring a whistleblower case, the experienced whistleblower attorneys at the Louthian Law Firm can review your case and help you file the appropriate disclosure statement. Under some circumstances, the government will intervene, or join in your lawsuit.

Your chances of succeeding are greater if your whistleblower claim is substantive, clear, and to the point.

Because of this, meeting with a qualified whistleblower attorney can increase your chances of winning. The Louthian Law Firm can help you form your claim so that the government will be more inclined to intervene in your case; government intervention can sometimes increase the chances of recovering reward money. Even if the government decides not to intervene, it could still be a good idea to pursue your case without government involvement. Our strong support system can assist you through every step of the process.

For a free, confidential evaluation of your case, call the Louthian Law Firm today at (803) 454-1200 or, if you prefer, you can fill out our online contact form.